pISSN 2287-2728 eISSN 2287-285X
Original Article
http://dx.doi.org/10.3350/cmh.2014.20.4.376 Clinical and Molecular Hepatology 2014;20:376-383
Effects of candesartan and propranolol combination therapy versus propranolol monotherapy in reducing portal hypertension Jae Hyun Kim1*, Jung Min Kim1*, Youn Zoo Cho1, Ji Hoon Na1, Hyun Sik Kim1, Hyoun A Kim1, Hye Won Kang1, Soon Koo Baik1,2, Sang Ok Kwon1, Seung Hwan Cha3, Young Ju Kim3, and Moon Young Kim1,2 1 Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju; 2Department of Cell Therapy and Tissue Engineering, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju; 3Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea
Background/Aims: Angiotensin receptor blockers (ARBs) inhibit activated hepatic stellate cell contraction and are thought to reduce the dynamic portion of intrahepatic resistance. This study compared the effects of combined treatment using the ARB candesartan and propranolol versus propranolol monotherapy on portal pressure in patients with cirrhosis in a prospective, randomized controlled trial. Methods: Between January 2008 and July 2009, 53 cirrhotic patients with clinically significant portal hypertension were randomized to receive either candesartan and propranolol combination therapy (26 patients) or propranolol monotherapy (27 patients). Before and 3 months after the administration of the planned medication, the hepatic venous pressure gradient (HVPG) was assessed in both groups. The dose of propranolol was subsequently increased from 20 mg bid until the target heart rate was reached, and the candesartan dose was fixed at 8 mg qd. The primary endpoint was the HVPG response rate; patients with an HVPG reduction of >20% of the baseline value or to
Original Article
http://dx.doi.org/10.3350/cmh.2014.20.4.376 Clinical and Molecular Hepatology 2014;20:376-383
Effects of candesartan and propranolol combination therapy versus propranolol monotherapy in reducing portal hypertension Jae Hyun Kim1*, Jung Min Kim1*, Youn Zoo Cho1, Ji Hoon Na1, Hyun Sik Kim1, Hyoun A Kim1, Hye Won Kang1, Soon Koo Baik1,2, Sang Ok Kwon1, Seung Hwan Cha3, Young Ju Kim3, and Moon Young Kim1,2 1 Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju; 2Department of Cell Therapy and Tissue Engineering, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju; 3Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea
Background/Aims: Angiotensin receptor blockers (ARBs) inhibit activated hepatic stellate cell contraction and are thought to reduce the dynamic portion of intrahepatic resistance. This study compared the effects of combined treatment using the ARB candesartan and propranolol versus propranolol monotherapy on portal pressure in patients with cirrhosis in a prospective, randomized controlled trial. Methods: Between January 2008 and July 2009, 53 cirrhotic patients with clinically significant portal hypertension were randomized to receive either candesartan and propranolol combination therapy (26 patients) or propranolol monotherapy (27 patients). Before and 3 months after the administration of the planned medication, the hepatic venous pressure gradient (HVPG) was assessed in both groups. The dose of propranolol was subsequently increased from 20 mg bid until the target heart rate was reached, and the candesartan dose was fixed at 8 mg qd. The primary endpoint was the HVPG response rate; patients with an HVPG reduction of >20% of the baseline value or to
